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Genetic counseling: Pituitary Tumor
Pituitary Tumor Introduction *Acknowledge prior contact and receipt of family history information *Assess the most important concerns since there are so many issues at hand *Discuss family plans (timing, size, etc.) and how those plans may be influenced by what is learned today Intake and Family History *Review family history information and personal health information already obtained *Use pedigree to make the review easier *Specifically ask about cancer in the family *Ask about pituitary tumor **When was it diagnosed? How? By whom? **What symptoms was she having? **Did she receive any treatment beside the drug mentioned? **Was surgery or radiation therapy ever discussed? **Has her physician discussed recurrence risks with her? What is the Pituitary Gland? *The pituitary gland is a small, bean-shaped gland located in the center of the brain just above the back of the nose *The pituitary gland makes hormones that affect the growth and functions of other glands in the body; therefore it is sometimes called the "master gland" *Some hormones produced by the pituitary include: Thyroid Stimulating Hormone, Growth Hormone, Adrenocorticotropic Hormone, Luteinizing and Follicle Stimulating Hormones, Vasopressin, and others *When there is an abnormality of the pituitary gland, it often produces either too much or too little of one or a combination of hormones. This can result in a variety of hormonal problems that can affect the whole body. *Enlargement of the gland can also cause visual disturbances and/or impairment Pituitary Tumors *Pituitary tumors or adenomas are almost always benign which means that they grow slowly and do not spread to other parts of the body *Pituitary tumors are rare. *Some may be "silent" lesions that are incidentally found at autopsy *The manifestations of a pituitary tumor depend on the hormones secreted by the tumor and the pattern of growth *Some hormonally active tumors are those that produce adrenocorticotropic hormone (ACTH), prolactin, or growth-hormone *Hormonally-inactive adenomas are often larger and may exhibit invasive properties. Thus, the likelihood for blindness is greater in patients with this tumor type *Pituitary tumors are seen in one of the multiple endocrine neoplasia (MEN) syndromes. MEN type I is well recognized, dominantly inherited, and comprises tumors of the parathyroid, pancreas and pituitary. Eighty percent of patients have involvement of 2 or more glands, and pituitary tumors occur in 54% to 80% of patients with MEN I. *MRI most readily determines the presence of a pituitary tumor, although it may also be established by CT (computer tomography) scan. *Many patients experience visual loss. Headaches occur in about 20%. Treatment *Treatment depends upon the type of tumor and if it extends into the brain around the pituitary. *Hormone-secreting tumors may be treated with surgery or radiation therapy. Drug therapy with bromocriptine has been used with success in patients with prolactin-secreting tumors. *Lesions that extend beyond the confines of the pituitary often require radiation therapy and surgery Risk for *I could not find a population rate for pituitary tumors, only that they are "very rare" *sister was probably treated with bromocriptine which was used in the past for lactation cessation and is currently used to treat prolactin-secreting pituitary tumors *Her tumor was likely small at the start, and she has responded well to treatment thus far *Even if sister has a recurrence of the tumor, it will not affect the risk that this couple would have a child with a pituitary tumor References *Buckman, Robert. What you Really Need to Know about Cancer, p61. *CancerNet (A service of the NCI) online database *DeVita, Vincent T., Samuel Hellman, and Steven A. Rosenbert. Cancer: Principles & Practice of Oncology. Volume 2: pp1725, 2066-2068 *Genetics in Clinical Oncology, pp108-109. *Pituitary Network Association (PNA) website Notes The information in this outline was last updated in 2002.